Colon Penetration by a Copper Intrauterine Device: a Case Report with Literature Review

Aim: The present case report describes colon injury subsequent to uterine penetration which is associated with the use of an intrauterine device (IUD).

Case: A 29-year-old multiparous woman, who presented with vague abdominal pain, had a TCu 380A inserted at her postpartum third month visit. The T-shaped segment of the IUD was found to be lodged within the lumen of a colon segment which was 60 cm far from the ileocecal valve. The vertical copper-bearing limb of the IUD extruded from the colon wall beyond the mesenteric edge and partially penetrated the fundal wall. After the affected colon segment was resected, an end-to-end anastomosis was made. Recovery period was uneventful.

Discussion: The incidence of uterine penetration is affected by the IUD type, the timing of insertion related to pregnancy termination, the position of uterus, insertion technique, the experience of the operator and the follow-up period. The location of missing IUDs can be determined by ultrasonography, X-ray or computed tomography imaging.